A growing number of people in Obamacare are finding out their health insurance plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise.

At least 1.4 million people in 32 states will lose the Obamacare plan they have now, according to state officials contacted by Bloomberg. That’s largely caused by Aetna Inc., UnitedHealth Group Inc. and some state or regional insurers quitting the law’s marketsfor individual coverage.

Sign-ups for Obamacare coverage begin next month. Fallout from the quitting insurers has emerged as the latest threat to the law, which is also a major focal point in the U.S. presidential election.

If we are to make healthcare affordable for everyone, the answer is not going to come from a President Hillary Clinton or a President Donald Trump. Instead, the solution can be found if we send healthcare back to the states where experimentation and innovative public policies can take place focusing on utilization and waste in healthcare.

It is there that we can look to states already on the move. Florida, Georgia, Tennessee and Alabama are considering a bold concept to reduce waste by reducing the need to practice of wasteful, defensive medicine.

Defensive medicine is any type of medical practice to avoid litigation such as tests, scans, medications and procedures.

Obamacare will likely see a “significant slowdown” in enrollment next year, a Thursday analysis from S&P Global Ratings projects.

The report suggests effectuated marketplace enrollment will range between 10.2 million and 11.6 million in 2017. The analysts say their forecast “is clearly a bump in the road, but doesn’t signal ‘game over’ for the marketplace.”

“The marketplace would benefit from growth in enrollment, especially if it helps improve the morbidity of the risk pool. But 2017 will likely not be the year the marketplace sees significant expansion,” the report says.

Obamacare was supposed to reduce health expenses for Americans, but that’s not how it’s working out.

Although many have benefited from government subsidies or the ability to buy insurance, health-care costs continue to rise and eat up a bigger percentage of household budgets.

In a recent though little-noticed study, economist Ann C. Foster at the Bureau of Labor Statistics found that health costs made up a record 8% of an average household’s budget in 2014, the last year for which data is available.

That’s a 40% jump compared to 10 years ago, and a 21% increase since 2010, the year the Patient Protection and Affordable Care Act was passed. Parts of the law were implemented shortly afterward but it wasn’t until 2014 that most of it took effect.

Ever since the Affordable Care Act’s insurance marketplaces opened for business in 2014, the Obama administration has worked hard to get Americans to sign up. Yet officials now are telling some older people that they might have too much insurance and should cancel their marketplace policies.

Each month, the Centers for Medicare and Medicaid Services is sending emails to about 15,000 people with subsidized marketplace coverage. The message arrives a few weeks before their 65th birthday, which is when most become eligible for Medicare.

When asked by a voter during Sunday night’s presidential debate what she would do about skyrocketing costs under Obamacare, Hillary Clinton praised the law’s expansion of coverage, and also vowed to “fix” the problems with the law to get costs under control. However, her plan for fixing Obamacare, far from solving its problems, would make many of them worse.

Broadly speaking, Clinton’s proposals boil down to increasing the amount that the federal government subsidizes and regulates healthcare. But Obamacare is rooted in the regulate and subsidize approach, and what has happened is that the regulations have driven up costs and even the hundreds of billions in subsidies aren’t enough to chase those higher costs.

The problems emerging in the exchanges are a symptom of a larger disease, which is that the ACA moved far too much power and regulatory control over the health sector to the federal government. Building a broader consensus around reform of the individual insurance market will almost certainly require revisiting other fundamental aspects of the ACA that have sharply divided policymakers.

The ACA exchanges will not be able to continue indefinitely without substantial reform. But reform will only be possible if the American public believes that this will not merely be another intrusion into their personal health decisions and their wallets. It will be up to Congress and the next President to decide if America’s health care system is worth the political risk needed to enact responsible and necessary reforms.